Highmark to Make Changes to Its Hospital Admitting Privileges Requirement

Last Updated: Jan 14, 2020

Hospital-Hallway-articleStarting Feb. 13, 2020, Highmark is making changes to its hospital admitting privileges requirement for practitioners.

The new policy requires the following:

  • Practitioners that are required to have hospital privileges – i.e. primary care and specialists – must have privileges in good standing at a Highmark network and/or Blue Cross and Blue Shield Association-participating hospital or have alternate arrangements for enrollees.
  • Primary care practitioners must have full admitting privileges.
  • The hospital where the practitioner has privileges must be participating in the same Highmark networks as the practitioner who is applying or being certified.

In Pennsylvania, this updated policy applies to physicians and certified registered nurse practitioners.

Read Highmark’s ebulletin on the admitting privileges changes here.

Pennsylvania Medical Society members with questions can contact our Knowledge Center at (855) 726-3348 or KnowledgeCenter@pamedsoc.org.

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